Abdominal aortic calcification linked to late-life dementia risk in older women: Lancet

Australia: Older women, with more advanced abdominal aortic calcification (AAC) on lateral spine images captured during bone density testing, have a higher risk of late-life dementia, states a study result published in The Lancet Regional Health -- Western Pacific.

Globally, more than 55 million people live with dementia. Dementia is the loss of cognitive functioning that interferes with an individual's daily life and activities. Dementia after 80 years (late-life) is increasingly common due to vascular and non-vascular risk factors but is not a part of normal aging. There is a strong link between vascular disease and dementia risk but data on whether extra-coronary vascular calcifications may be a marker of later-life dementia risk is scarce. The abdominal aorta is one of the first sites where vascular calcification is seen and abdominal aortic calcification (AAC) is common in older men and women. So far, there has been no study investigating the association between AAC and dementia risk. Identifying individuals at higher risk of late-life dementia remains a global priority.

Tenielle P., Curtin University, Australia, and colleagues conducted a study to determine whether AAC assessed on images captured using widely available bone density machines would be a stable marker of accumulated vascular damage and as such associated with a higher risk of late-life dementia.

Researchers used lateral spine images (LSI) captured from a bone density machine of 958 ambulant community-dwelling older women (≥70 years) to assess AAC. AAC was classified into established categories (low, moderate, and extensive). Cardiovascular risk factors and apolipoprotein E (APOE) genotyping were evaluated. Incident 14.5-year late-life dementia was identified from linked hospital and mortality records.

Key findings of the study,

• At baseline women were 75.0 ± 2.6 years, 44.7% had low AAC, 36.4% had moderate AAC and 18.9% had extensive AAC

• Over 14.5- years, 150 (15.7%) women had a late-life dementia hospitalisation (n = 132) and/or death (n = 58).

• Compared to those with low AAC, women with moderate and extensive AAC were more likely to suffer late-life dementia hospitalizations and deaths

• After adjustment for cardiovascular risk factors and APOE, women with moderate and extensive AAC had twice the relative hazards of late-life dementia compared to women with low AAC.

The authors concluded that there is an association between AAC and the subsequent development of late-life dementia in older women, independent of cardiovascular risk factors and APOE genotype. The risk of hospitalization and death from dementia increases significantly with an increase in the severity of AAC.

Given the widespread use of bone density testing, simultaneously capturing AAC information may be a novel, non-invasive, scalable approach to identifying late-life dementia risk in older women and implementing early lifestyle intervention strategies in at-risk populations, the authors wrote.

Reference:

The study titled, "Abdominal aortic calcification on lateral spine images captured during bone density testing and late-life dementia risk in older women: A prospective cohort study," was published in The Lancet Regional Health – Western Pacific. 

DOI: https://doi.org/10.1016/j.lanwpc.2022.100502